Optimal Portal Venous Circulation for Liver Graft Function after Living-Donor Liver Transplantation
- 15 February 2006
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Transplantation
- Vol. 81 (3), 373-378
- https://doi.org/10.1097/01.tp.0000198122.15235.a7
Abstract
Background. Previous studies have shown poor outcome after living-donor liver transplantation (LDLT) as a result of excessive portal venous pressure (PVP), excessive portal venous flow (PVF), or inadequate PVF. We investigated optimal portal venous circulation for liver graft function after LDLT in adult recipients retrospectively. Methods. Between June 2003 and November 2004, 28 adult patients underwent LDLT in our institution. We modulated PVP under 20 mmHg in these 28 cases by performing a splenectomy (n=4) or splenorenal shunt (n=1). The PVF and PVP were measured at the end of the operation. Compliance was calculated by dividing PVF by PVP. Results. PVF and compliance showed a significant inverse correlation with peak billirubin levels after LDLT (r = -0.63: r=−0.60, P<0.01), and with peak international normalized ratio after LDLT (r=−0.41: r=−0.51, P<0.05). Compliance was higher in right-lobe graft with middle hepatic vein cases (148±27 ml/min/mmHg), and lower in left-lobe graft cases (119±50 ml/min/mmHg). Conclusions. Liver graft function was better when PVF and graft compliance were higher and PVP was maintained under 20 mmHg.This publication has 21 references indexed in Scilit:
- Impact of portal venous pressure on regeneration and graft damage after living-donor liver transplantationLiver Transplantation, 2004
- End-to-side portocaval shunting for a small-for-size graft in living donor liver transplantationLiver Transplantation, 2004
- Clinical relevance of adapting portal vein flow in living donor liver transplantation in adult patientsLiver Transplantation, 2003
- Portomesenteric disconnection for small-for-size grafts in liver transplantation: Preclinical studies in pigsLiver Transplantation, 2003
- Portal hyperperfusion injury as the cause of primary nonfunction in a small-for-size liver graft-successful treatment with splenic artery ligationLiver Transplantation, 2003
- Portal vein pressure is the key for successful liver transplantation of an extremely small graft in the pig modelTransplant International, 2003
- Effect of mesocaval shunt on survival of small-for-size liver grafts: experimental study in pigsTransplantation, 2003
- Changes in portal venous pressure in the early phase after living donor liver transplantation: pathogenesis and clinical implications1,2Transplantation, 2003
- Small-for-size partial liver graft in an adult recipient; a new transplant techniqueThe Lancet, 2002
- Excessive portal venous inflow as a cause of allograft dysfunction in small-for-size living donor liver transplantationTransplantation Proceedings, 2001